The Centers for Medicare & Medicaid Services (CMS) announced in early February that it will initiate the Prior Authorization of Power Mobility Devices (PMDs) Demonstration Program “on or after” June 1, 2012. The demonstration will implement a prior authorization process for scooters and power wheelchairs, “to help ensure that a beneficiary’s medical condition warrants their medical equipment under existing coverage guidelines.”
The PMD demonstration had been scheduled to begin Jan. 1, 2012, but was delayed because of feedback CMS had received from providers and suppliers affected by the program. In response to concerns from those parties, CMS has made two important modifications to the program:
CMS will allow PMD providers to submit prior authorization requests on behalf of physicians.
The Prior Authorization of PMDs Demonstration Program will be initiated in California, Illinois, Michigan, New York, North Carolina, Florida, and Texas. These states have been targeted due to high populations of fraud- and error-prone providers.
For more information, see the Prior Authorization of Devices (PMDs) Demonstration Fact Sheet.